IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0089692.html
   My bibliography  Save this article

School Based Sex Education and HIV Prevention in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Author

Listed:
  • Virginia A Fonner
  • Kevin S Armstrong
  • Caitlin E Kennedy
  • Kevin R O'Reilly
  • Michael D Sweat

Abstract

Objectives: School-based sex education is a cornerstone of HIV prevention for adolescents who continue to bear a disproportionally high HIV burden globally. We systematically reviewed and meta-analyzed the existing evidence for school-based sex education interventions in low- and middle-income countries to determine the efficacy of these interventions in changing HIV-related knowledge and risk behaviors. Methods: We searched five electronic databases, PubMed, Embase, PsycInfo, CINAHL, and Sociological Abstracts, for eligible articles. We also conducted hand-searching of key journals and secondary reference searching of included articles to identify potential studies. Intervention effects were synthesized through random effects meta-analysis for five outcomes: HIV knowledge, self-efficacy, sexual debut, condom use, and number of sexual partners. Results: Of 6191 unique citations initially identified, 64 studies in 63 articles were included in the review. Nine interventions either focused exclusively on abstinence (abstinence-only) or emphasized abstinence (abstinence-plus), whereas the remaining 55 interventions provided comprehensive sex education. Thirty-three studies were able to be meta-analyzed across five HIV-related outcomes. Results from meta-analysis demonstrate that school-based sex education is an effective strategy for reducing HIV-related risk. Students who received school-based sex education interventions had significantly greater HIV knowledge (Hedges g = 0.63, 95% Confidence Interval (CI): 0.49–0.78, p

Suggested Citation

  • Virginia A Fonner & Kevin S Armstrong & Caitlin E Kennedy & Kevin R O'Reilly & Michael D Sweat, 2014. "School Based Sex Education and HIV Prevention in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-18, March.
    • Handle: RePEc:plo:pone00:0089692
    DOI: 10.1371/journal.pone.0089692
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089692
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0089692&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0089692?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Halpern, Carolyn Tucker & Mitchell, Ellen M.H. & Farhat, Tilda & Bardsley, Phil, 2008. "Effectiveness of web-based education on Kenyan and Brazilian adolescents' knowledge about HIV/AIDS, abortion law, and emergency contraception: Findings from TeenWeb," Social Science & Medicine, Elsevier, vol. 67(4), pages 628-637, August.
    3. Kirby, Douglas & Coyle, Karin, 1997. "School-based Programs to Reduce Sexual Risk-taking Behavior," Children and Youth Services Review, Elsevier, vol. 19(5-6), pages 415-436.
    4. Klepp, K.-I. & Ndeki, S.S. & Leshabari, M.T. & Hannan, P.J. & Lyimo, B.A., 1997. "AIDS education in Tanzania: Promoting risk reduction among primary school children," American Journal of Public Health, American Public Health Association, vol. 87(12), pages 1931-1936.
    5. Gallant, Melanie & Maticka-Tyndale, Eleanor, 2004. "School-based HIV prevention programmes for African youth," Social Science & Medicine, Elsevier, vol. 58(7), pages 1337-1351, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kim, Jiin & Huh, Jin & Yoo, Sung-Sang, 2023. "Implementation of reproductive health education in a Filipino city: A case study," International Journal of Educational Development, Elsevier, vol. 100(C).
    2. Alberto Chong & Marco Gonzalez-Navarro & Dean Karlan & Martín Valdivia, 2020. "Do Information Technologies Improve Teenagers’ Sexual Education? Evidence from a Randomized Evaluation in Colombia," The World Bank Economic Review, World Bank, vol. 34(2), pages 371-392.
    3. Fatima Zahra & Nicole Haberland & Stephanie Psaki, 2022. "PROTOCOL: Causal mechanisms linking education with fertility, HIV, and child mortality: A systematic review," Campbell Systematic Reviews, John Wiley & Sons, vol. 18(2), June.
    4. Devi Leena Bose & Anhad Hundal & Sabina Singh & Shweta Singh & Kuhika Seth & Saif ul Hadi & Ashrita Saran & Jessy Joseph & Kriti Goyal & Solomon Salve, 2023. "Evidence and gap map report: Social and Behavior Change Communication (SBCC) interventions for strengthening HIV prevention and research among adolescent girls and young women (AGYW) in low‐ and middl," Campbell Systematic Reviews, John Wiley & Sons, vol. 19(1), March.
    5. Victor Orozco-Olvera & Fuyuan Shen & Lucie Cluver, 2019. "The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    6. Morales, Alexandra & Garcia-Montaño, Eileen & Barrios-Ortega, Cristian & Niebles-Charris, Janivys & Garcia-Roncallo, Paola & Abello-Luque, Daniella & Gomez-Lugo, Mayra & Saavedra, Diego Alejandro & Va, 2019. "Adaptation of an effective school-based sexual health promotion program for youth in Colombia," Social Science & Medicine, Elsevier, vol. 222(C), pages 207-215.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Duflo, Esther & Dupas, Pascaline & Kremer, Michael & Sinei, Samuel, 2006. "Education and HIV/AIDS prevention : evidence from a randomized evaluation in Western Kenya," Policy Research Working Paper Series 4024, The World Bank.
    2. Zohra S. Lassi & Sophie G. E. Kedzior & Wajeeha Tariq & Yamna Jadoon & Jai K. Das & Zulfiqar A. Bhutta, 2021. "Effects of preconception care and periconception interventions on maternal nutritional status and birth outcomes in low‐ and middle‐income countries: A systematic review," Campbell Systematic Reviews, John Wiley & Sons, vol. 17(2), June.
    3. İlkay Unay-Gailhard & Mark A. Brennen, 2022. "How digital communications contribute to shaping the career paths of youth: a review study focused on farming as a career option," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 39(4), pages 1491-1508, December.
    4. Yao Yao, 2022. "Fertility and HIV Risk in Africa," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 109-133, July.
    5. Mahin Ghafari & Vali Baigi & Zahra Cheraghi & Amin Doosti-Irani, 2016. "The Prevalence of Asymptomatic Bacteriuria in Iranian Pregnant Women: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-10, June.
    6. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    7. Santos Urbina & Sofía Villatoro & Jesús Salinas, 2021. "Self-Regulated Learning and Technology-Enhanced Learning Environments in Higher Education: A Scoping Review," Sustainability, MDPI, vol. 13(13), pages 1-12, June.
    8. Oded Berger-Tal & Alison L Greggor & Biljana Macura & Carrie Ann Adams & Arden Blumenthal & Amos Bouskila & Ulrika Candolin & Carolina Doran & Esteban Fernández-Juricic & Kiyoko M Gotanda & Catherine , 2019. "Systematic reviews and maps as tools for applying behavioral ecology to management and policy," Behavioral Ecology, International Society for Behavioral Ecology, vol. 30(1), pages 1-8.
    9. Nadine Desrochers & Adèle Paul‐Hus & Jen Pecoskie, 2017. "Five decades of gratitude: A meta‐synthesis of acknowledgments research," Journal of the Association for Information Science & Technology, Association for Information Science & Technology, vol. 68(12), pages 2821-2833, December.
    10. Alene Sze Jing Yong & Yi Heng Lim & Mark Wing Loong Cheong & Ednin Hamzah & Siew Li Teoh, 2022. "Willingness-to-pay for cancer treatment and outcome: a systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(6), pages 1037-1057, August.
    11. Xue-Ying Xu & Hong Kong & Rui-Xiang Song & Yu-Han Zhai & Xiao-Fei Wu & Wen-Si Ai & Hong-Bo Liu, 2014. "The Effectiveness of Noninvasive Biomarkers to Predict Hepatitis B-Related Significant Fibrosis and Cirrhosis: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-16, June.
    12. Vicente Miñana-Signes & Manuel Monfort-Pañego & Javier Valiente, 2021. "Teaching Back Health in the School Setting: A Systematic Review of Randomized Controlled Trials," IJERPH, MDPI, vol. 18(3), pages 1-18, January.
    13. Agnieszka A. Tubis & Katarzyna Grzybowska, 2022. "In Search of Industry 4.0 and Logistics 4.0 in Small-Medium Enterprises—A State of the Art Review," Energies, MDPI, vol. 15(22), pages 1-26, November.
    14. Obsa Urgessa Ayana & Jima Degaga, 2022. "Effects of rural electrification on household welfare: a meta-regression analysis," International Review of Economics, Springer;Happiness Economics and Interpersonal Relations (HEIRS), vol. 69(2), pages 209-261, June.
    15. Caloffi, Annalisa & Colovic, Ana & Rizzoli, Valentina & Rossi, Federica, 2023. "Innovation intermediaries' types and functions: A computational analysis of the literature," Technological Forecasting and Social Change, Elsevier, vol. 189(C).
    16. García-Poole, Chloe & Byrne, Sonia & Rodrigo, María José, 2019. "How do communities intervene with adolescents at psychosocial risk? A systematic review of positive development programs," Children and Youth Services Review, Elsevier, vol. 99(C), pages 194-209.
    17. Jie Zhao & Ji Chen & Damien Beillouin & Hans Lambers & Yadong Yang & Pete Smith & Zhaohai Zeng & Jørgen E. Olesen & Huadong Zang, 2022. "Global systematic review with meta-analysis reveals yield advantage of legume-based rotations and its drivers," Nature Communications, Nature, vol. 13(1), pages 1-9, December.
    18. Qing Ye & Bao-Xin Qian & Wei-Li Yin & Feng-Mei Wang & Tao Han, 2016. "Association between the HFE C282Y, H63D Polymorphisms and the Risks of Non-Alcoholic Fatty Liver Disease, Liver Cirrhosis and Hepatocellular Carcinoma: An Updated Systematic Review and Meta-Analysis o," PLOS ONE, Public Library of Science, vol. 11(9), pages 1-17, September.
    19. Bishal Mohindru & David Turner & Tracey Sach & Diana Bilton & Siobhan Carr & Olga Archangelidi & Arjun Bhadhuri & Jennifer A. Whitty, 2020. "Health State Utility Data in Cystic Fibrosis: A Systematic Review," PharmacoEconomics - Open, Springer, vol. 4(1), pages 13-25, March.
    20. Subramaniam, Mega & Pang, Natalie & Morehouse, Shandra & Asgarali-Hoffman, S. Nisa, 2020. "Examining vulnerability in youth digital information practices scholarship: What are we missing or exhausting?," Children and Youth Services Review, Elsevier, vol. 116(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0089692. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.